Surgical Treatment of Liver Cancer

Ken Takasaki

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College

Surgical resection of the primary tumor together with intrahepatic metastases in the surrounding liver tissue is the most effective therapy for hepatocellular carcinoma. Apart from improving radicality, future efforts should be directed toward enhancing safety by minimizing surgical damage and promoting the patient's prompt return to society. Improved safety of the operation requires an understanding of the limits to which patients can tolerate resection, as evaluated by using a table for estimation of remaining liver function. A11 types of resection should be performed systematically by using Glisson's sheath pedicle transection method. Perioperative management should be simple and avoid unnecessary use of lifesupport equipment. Adherence to this policy resulted in a mean postoperative hospital stay of 16.1 days. In addition, 70% of all patients recovered normally after the operation and were discharged after a mean postoperative hospital stay of 10.9 days. Delayed discharge was caused by late removal of the drain due to the presence of bile in the drainage postoperatively. This was apparently caused by damaging small bile ducts during ablation of the intrahepatic Glisson's sheath branch. Avoidance of this complication is one of our future goals.

Key words
liver cancer therapy, hepatectomy, Glisson's sheath pedicle transection method

Reprint requests
Ken Takasaki Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawadacho, Shinjuku, Tokyo, 162 JAPAN

Accepted
June 14, 1995

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